It cannot be a "perversion" in and of itself. It might be a MISTAKE - like getting a permanent tattoo and regretting it later in life - but all they are doing directly is affecting themselves. As long as they are ADULTS, it's their choice to make. And for a very few, it is genuinely a lifeline, and I don't see why it's anyone else's concern. They may get into "perversion" later, but that is as true of non-trans and the person may have done that with or without becoming trans-sexual.

As for obesity, its a very complex topic. I used to think, up to a few years ago, it was simple math - calories in, v calories burned. Being a hardcore ectomorph, I never realised just how good I had it. I've been living with someone moderately obese for the past few years, and we share 90%+ the same diet. I was confident she'd lose weight. :) She didn't. :(

It's very complex.

Obviously though, not everyone obese has Cartman's large bones either.

Americans who are obese I strongly think it is the psychological damaging of the culture, the WILFUL damaging effect of the mass culture, combined with the horrendous processed foods and ingredients thereof, which are EVERYWHERE. Combine depression with toxic foods in every direction, and you get voila.

So yes psychological - caused by the culture, and yes physiological - some are naturally heavier and light; and also environment, the toxic crap pumped out and advertised on TV and everywhere.

TBH, I don't think surgery to tighten the stomach will actually do sweet FA in the long term, unless the person makes an effort at the same time to turn their life around, and change their diet permanently too.

Their bodies reflect their societies.